DISEASES TREATED AT THE MAGWISE CLINIC

Depression

Causes of depression

Depression is a disease that we still know very little about. There are probably many reasons for it, and they are very complex. To fully understand this disease phenomenon, an essential element is missing - a complete knowledge of the mechanisms of the brain. Neuroscientists, after years of research, seem to agree that the most likely cause of endogenous depression is the underactivity of the prefrontal cortex and its connections with other brain structures.

Symptoms of depression

The symptoms of depression are different and numerous. However, there is a primary group that we include among the most common symptoms of depression reported by patients in doctors' offices:

The feeling of constant fatigue and heaviness
Reluctance to perform daily activities and work, loss of interest
So-called anhedonia - "nothing interests," "nothing pleases" - loss of joy of life, dissatisfaction with life, reluctance to live, suicidal thoughts
Deterioration of memory, difficulty focusing attention, impaired concentration, constant worrying,
The feeling of inner tension or anxiety
Avoiding friends, isolating yourself
Sleep disorders - shallow sleep, especially early awakening
Feeling worse in the morning
Loss of appetite, weight loss
Psychosomatic pains in various parts of the body, e.g., head, different muscle groups

Treatment-resistant depression

Szczególnym rodzajem depresji jest depresja lekooporna lub inaczej depresja oporna na leczenie (ang. TRD, treatment-resistand depression).

The STAR*D (Sequenced Treatment Alternatives to Relieve Depression) study was the most extensive study ever conducted on treating treatment-resistant depression. The study aimed to identify effective treatments for people suffering from depression who did not respond to standard antidepressant therapies. The results of the STAR*D study showed that each successive trial of antidepressant treatment is less effective than the previous one (27%, 21%, 16%, and 6%, respectively). The fifth and subsequent attempts to start antidepressants give only less than a 5% chance of cure. In this case, it is worth using biological treatment, such as transcranial magnetic stimulation (rTMS), which, depending on the protocol used, leads to a cure in 55% to 80% of patients. In January 2023, the first scientific evidence was published for the effectiveness of another brain neurostimulation technique in treating mood disorders, namely transcranial impulse stimulation (TPS). This method, by a result of the so-called mechanotransduction and stimulating neoangiogenesis, normalizes the malfunctioning prefrontal cortex, which translates into an antidepressant effect.

Treatment of depression

Treatment of depression usually includes several available methods, and the best results are obtained by combining them.

Psychotherapy
Pharmacotherapy (antidepressants, ketamine therapy)
Convulsion treatment (electroconvulsive, magnetic shock)
Neurostimulation, i.e., non-invasive methods of brain stimulation (NIBS, non-invasive brain stimulation) - e.g., TMS (Transcranial Magnetic Stimulation), TPS (Transcranial Pulse Stimulation), tDCS (Transcranial Direct Current Stimulation), VNS (Vagus Nerve Stimulation)
Neurosurgical treatment - implantation of an electrode for deep brain stimulation (DBS)

Depression treatment available at Magwise

Integrative psychotherapy, CBT, schemas, EMDR
Pharmacotherapy under the supervision of a specialist psychiatrist
TMS Neurostimulation (Transcranial Magnetic Stimulation)
TPS neurostimulation (transcranial impulse stimulation)

Who do we treat?

At Magwise, we have specialized in treating depression using brain neurostimulation from the beginning. We are the largest center of this type in Poland.

People suffering from the so-called treatment-resistant depression (TRD)

Depressed persons for whom antidepressants give little improvement or have unbearable side effects

People with depression who refuse to be treated with medication

Depression in the course of bipolar disorder (BPAD)

Depression during pregnancy and postpartum depression during breastfeeding as an alternative to pharmacological treatment

Depression in the course of Alzheimer's disease

References

Sinyor M, Schaffer A, Levitt A. The sequenced treatment alternatives to relieve depression (STAR*D) trial: a review. Can J Psychiatry. 2010 Mar;55(3):126-35. doi: 10.1177/070674371005500303. PMID: 20370962.
De Risio L, Borgi M, Pettorruso M, Miuli A, Ottomana AM, Sociali A, Martinotti G, Nicolò G, Macrì S, di Giannantonio M, Zoratto F. Recovering from depression with repetitive transcranial magnetic stimulation (rTMS): a systematic review and meta-analysis of preclinical studies. Transl Psychiatry. 2020 Nov 10;10(1):393. doi: 10.1038/s41398-020-01055-2. PMID: 33173042; PMCID: PMC7655822.
Cheung T, Li TMH, Ho YS, Kranz G, Fong KNK, Leung SF, Lam SC, Yeung WF, Lam JYT, Fong KH, Beisteiner R, Xiang YT, Cheng CPW. Effects of Transcranial Pulse Stimulation (TPS) on Adults with Symptoms of Depression-A Pilot Randomized Controlled Trial. Int J Environ Res Public Health. 2023 Jan 28;20(3):2333. doi: 10.3390/ijerph20032333. PMID: 36767702; PMCID: PMC9915638.